A 6-year-old boy in Salt Lake City, Utah, recently had plastic surgery to make his ears stick out less, and parents everywhere weighed in on the family's decision, perhaps without knowing all of the facts about this operation.

The young boy had been bullied because of his ears — his classmates had referred to them as "elf ears," Inside Edition originally reported. The boy and his parents opted for the surgery because they feared the effects bullying could have on him.

In fact, this type of surgery is becoming more common, said Dr. David Staffenberg, chief of pediatric plastic surgery at NYU Langone Medical Center in New York City.

Part of the reason for the increasing popularity of the operation, called otoplasty, is that people are more aware of the surgery, thanks, in part, to the Internet, Staffenberg told Live Science. In the past, people might have thought the operation was rare and thus did not see it as a solution, he said. [10 Scientific Tips for Raising Happy Kids]

But parents shouldn't feel conflicted if they choose this option for their child, he said.

"One of the confusing things parents battle with is the incorrect notion that this kind of surgery is for vanity, or purely cosmetic," Staffenberg said. "That brings out a lot of guilty feelings."

Dr. Jeffrey Ascherman, chief of the Division of Plastic Surgery at Columbia University in New York City, agreed.

"You could argue that this is a reconstructive surgery," Ascherman told Live Science. Reconstructive surgery involves returning a feature to a "normal" appearance, whereas cosmetic surgery involves enhancing a "normal" feature, he said.

Age matters

It isn’t clear exactly how many of these surgeries are performed every year. The American Society of Plastic Surgeons does track such surgical procedures, but not for children younger than teens.

Although age 6 may sound young for an elective surgery, parents can opt for their kids to have the procedure when their kids are even younger.

In fact, parents are increasingly addressing prominent ears in newborns, Staffenberg said.

During the first few weeks of an infant's life, the cartilage in the ears is more moldable, meaning doctors can reshape the ears without surgery, Staffenberg said.

However, there's a short window for a nonsurgical option. After the first few weeks of infancy, the cartilage in the ear is no longer moldable — but it's not stiff enough for surgery, either, Staffenberg said. For this reason, if they miss the short window, parents need to wait until the child is a bit older — until at least age 5 — to have surgery, he said.

But putting off the surgery isn't always the best call, Staffenberg said.

Patients who come in for the surgery when they're adults have "already endured a lifetime of teasing and bullying," Staffenberg said.

Ascherman also said he has seen patients who have put off the surgery, but some of those people have spent their lives covering their ears because they felt conspicuous, he said.

Ear anatomy

One of the biggest misconceptions about ears that stick out is that they're too big. In most instances, this is not the case. Rather, it's just that the ear structure is turned outward, Staffenberg said.

But ears don't all stick out for the same reasons. Each patient's anatomy determines what type of ear surgery he or she needs, Staffenberg said.

For some, such as the boy in Utah, surgeons need to correct a small fold in the cartilage, known as the antihelix, that caused the ears to turn out more than usual, Staffenberg said.

For others, the ears are rotated forward more. In these cases, surgeons can remove some of the tissue behind the ear to make more space, Ascherman said.

There are also cases in which parts of the ear are just large, but these are less common, Ascherman said. In these cases, surgery involves removing some of the cartilage, Ascherman added.

Although some kids may be bullied for having ears that stick out, it isn't always a bad thing: A 2015 study found that kids whose ears stick out are cuter.  

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